DNP Scholarly Projects


Local and immersion service learning methods prepare pre-licensure health care professionals to deliver culturally competent care to diverse populations- an important need because of the rapid racial and ethnic diversity growth in the U.S. A mixed-methods approach compared the effect of local and immersion service learning methods on multiple disciplines of pre-licensure health care students’ confidence in delivering care to diverse populations. Guided by Jeffreys (2016) CCC Model, the Transcultural Self Efficacy Tool (TSET) was used to compare pre-licensure health care students’ (n=34) transcultural self-efficacy perceptions following local or immersion service learning experiences. Secondary source, qualitative data obtained from post-immersion trip surveys from pre-licensure health care students’ (n=13) was utilized to further examine quantitative data results, and name themes that arose from students’ immersion service learning experience. Pre- and posttest TSET scores were analyzed based on total scores and subscale (cognitive, practical, and affective) scores. A paired samples t-test compared post-test scores of the local and immersion service learning groups. An open coding strategy was utilized on qualitative data. A significant increase was demonstrated in the post-test scores of both local and immersion service learning groups. The local group demonstrated a significant increase in the practical and affective subscales, and the immersion group demonstrated a significant increase in the cognitive and practical subscales. Qualitative data yielded the major concept of “cultural competence” with the themes of “comprehension”, “compounded experiential learning”, “skill development”, “interaction”, and “affective”. Local and immersion service learning methods are effective in improving the transcultural self-efficacy in pre-licensure health care students and produce outcomes that meet the national and professional goals for providing culturally competent health care to diverse populations.



First Advisor

Wofford, Linda G.

Scholarly Project Team Member

Busby, Steve

Scholarly Project Team Member

Price, Joseph

Scholarly Project Team Member

Taplin, Susan

Scholarly Project Team Member

Amerson, Roxanne


Nursing, School of


Health Sciences & Nursing, Gordon E. Inman College of

Document Type

Scholarly Project


Doctorate of Nursing Practice (DNP)

Degree Level


Degree Grantor

Belmont University


Cultural competence; Service learning; Medical personnel; Cultural competence

Included in

Nursing Commons